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General NPI Number Information
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NPI Number | 1538464706
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Entity Type | Organization
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Legal Business Name | YUCAIPA HEARING AID CENTER, INC
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Dates
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Enumeration Date | 01/20/2011
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Last Update Date | 01/20/2011
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Provider Practice Location Address
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Address Line | 12197 CALIFORNIA ST
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City | YUCAIPA
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State | CA
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Zip | 92399-4332
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Country | US
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Telephone | 909-797-2104
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Fax | 909-797-6724
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Provider Business Mailing Address
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Address Line | 12197 CALIFORNIA ST
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City | YUCAIPA
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State | CA
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Zip | 92399-4332
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Country | US
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Telephone | 909-797-2104
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Fax | 909-797-6724
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Authorized Official
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Title or Position | VP OPERATIONS
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Name | MS. STEPHANIE K WOOD
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Credential |
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Telephone | 909-797-2104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | HA5067
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | HA5067
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License Number State | CA
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